[Repeat prosthetic repair of the internal carotid artery]. / Operatsiia povtornogo protezirovaniia vnutrennei sonnoi arterii.

Described herein is a clinical case report regarding reoperation on carotid arteries for thrombosis of a synthetic graft of the internal carotid artery in a patient presenting with a multifocal atherosclerotic lesion. Despite medicamentous treatment carried out after the primary operation, the presence of major risk factors had unfavourably contributed to progression of the disseminated atherosclerotic process. During eight years, the patient had endured reconstructive interventions on the brachiocephalic and coronary arteries, as well as on the vessels of the iliac-femoral-popliteal segment. Taking into consideration the peculiarities of the vascular anatomy, the degree of stenosis of the internal carotid artery with the presence of thrombotic masses in the lumen, and thrombosis inside the graft, a decision was made to perform repeat "open" reconstruction consisting in successful common carotid-internal carotid prosthetic repair using a synthetic graft with resection of the external carotid artery.

[Secondary intrathoracic reconstruction after prosthetic repair of the brachiocephalic trunk for traumatic aneurysm of the right subclavian artery].

The article deals with a case report of successful secondary surgical treatment of a patient who endured prosthetic repair of the brachiocephalic trunk for a traumatic false aneurysm of the right subclavian artery complicated by thrombosis of the reconstruction zone. Long-term conservative treatment resulted in progression of cerebrovascular insufficiency, invalidization, increasing ischaemia of the right upper limb, which required performing secondary intrathoracic reconstruction with prosthetic repair of the common carotid artery, vertebral artery and axillary artery on the right. Presented herein are the results of check up contrast-enhanced and CT-angiography performed at 10 months after the operation.

[Intraoperative assessment of blood flow along coronary and internal thoracic arteries before and after myocardial revascularization].

The article deals with intraoperative assessment of the blood flow in the coronary arteries and internal thoracic artery before and after myocardial revascularization. This is accompanied and followed by ultrasonographic characteristics of the coronary blood flow before and after surgical intervention, as well as competence of anastomoses and functional state of revascularization depending on the degree of the atherosclerotic lesion and the diameter of coronary arteries. The average linear and volumetric velocities of the blood flow in the coronary arteries were found to depend upon the degree of the lesion of coronary arteries, the diameter and capacity of the coronary bed. The work was based on studying a total of forty-eight patients presenting with coronary artery disease and subjected to myocardial revascularization using the internal thoracic artery (ITA). Also determined was efficacy of myocardial revascularization in different diameters of the coronary arteries and parameters of the ITA blood flow.

[Outcomes of surgical management of elderly and aged patients with complicated forms of coronary artery disease].

The article is dedicated to comparative analysis of surgical management of elderly and aged patients presenting with complicated forms of coronary artery disease (CAD). Suggested herein is an algorithm of concerning the choice of methods aimed at surgical correction of postinfarction aneurysms of the right ventricle of the heart and postinfarction ruptures of the interventricular septum in these patients, depending on the morphological structure of the right-ventricular postinfarction aneurysms and postinfarction ruptures of the interventricular septum, followed by determining the incidence rate of using "complete" and "incomplete" myocardial revascularization in elderly and aged patients with complicated forms of CAD depending on peculiarities of the coronary blood flow. Also considered herein is efficacy of preventing rethrombosis following correction of right-ventricular postinfarction aneurysms and thrombectomy. The article is based on studying a total of forty-two 60-to-78-year-old patients with CAD. The measures taken made it possible to decrease postoperative lethality and postoperative complications rate in the patients concerned.

[Vasonit retard in the treatment of intermittent claudication in patients with obliterating diseases of the lower extremities]. / Vazonit retard v lechenii bol'nykh s peremezhaiushcheisia khromotoi pri obliteriruiushchikh zabolevaniiakh arterii nizhnikh konechnostei.

This paper deals with an open no incomparable study of the efficacy of vasonit retard in the treatment of intermittent claudication in patients suffering from arterial pathology. The efficacy and tolerance of vasonit retard were investigated for two months at the A.V. Vishnevsky Institute of Surgery, RAMS, and at 20 vascular departments of Russia (Moscow, Sankt-Peterburg, Nizhny Novgorod, Perm, Yaroslavl, Volgograd, Omsk, Irkutsk, Chelyabinsk, Voronezh, Rostov-on-Don, Ekaterinburg). The study accrued 25 patients treated at the A.V. Vishnevsky Institute of Surgery, RAMS, and 348 patients treated on the basis of 20 vascular departments of Russia, The basic criterion for inclusion into the study was the presence in the patient of intermittent claudication, corresponding to extremity ischemia, degree IIA end, IIB, according to the A.V.Pokrovsky classification. The treatment by vasonit retard was conducted outpatiently. The drug was administered in a daily dose of 1200 mg for 2 months. After treatment the ankle/brachial index along the posterior tibial artery and dorsalis pedis artery rose by over 17% in the group treated pt the Institute of Surgery and by over 21.5% in the group which participated in the multicenter study. The minimal pain-free distance increased by 60% and 115% respectively. The maximal pain-free distance rose by 37.7% and 98.4% respectively. A 25% abatement of the pain intensity (according to the pain score) was recorded in the group seen at the Institute of Surgery and a 36.1% pain abatement in the group included into the multicenter study. No complications leading to drug discontinuation were marked. Thus, talking into account the clinical evidence and the data supplied by instrumental diagnostic techniques, it is necessary to admit that vasonit retard is an effective drug for the treatment of patients suffering from intermittent claudication.